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ARTICLE |

Paradoxical Septal Motion Secondary to Right Ventricular Tumor FREE

Lewis Sassé, MD; Donald Lorentzen, MD; Hector Alvarez, MD
[+] Author Affiliations

Reprint requests to Department of Education and Research, Southern California Permanente Medical Group, 4900 Sunset Blvd, Los Angeles, CA 90027 (Dr. Sassé).


JAMA. 1975;234(9):955-956. doi:10.1001/jama.1975.03260220059022
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TO OUR knowledge, this is the first report of echocardiographically studied rhabdomyosarcoma of the heart. Square-wave paradoxical septal motion was noted. In the absence of previously reported causes of paradoxical septal motion, right ventricular tumor appears to be a newly recognized cause of paradoxical septal motion.

Report of a Case  A normotensive 59-year-old woman with a long history of spastic colon symptoms was admitted during a bout of near syncope. A presystolic "seagull" murmur at the lower part of the left sternal border and elevated jugular venous pressure, both of which increased on inspiration, an early systolic ejection murmur, which decreased with inspiration, a prominent jugular A wave, and a normal second heart sound were demonstrated (Fig 1). There was mild peripheral cyanosis. Electrocardiographic axis was +120°, with tall R waves in right precordial leads and a QRS complex duration of 0.10 seconds, while an electrocardiogram eight months earlier was

REFERENCES

Bemis EL, Pemberton AH, Lurie A:  Rhabdomyosarcoma of the heart . Cancer 29:924-929, 1972;.
Goodman DJ, Harrison DC, Popp RL:  Echocardiographic features of primary pulmonary hypertension . Am J Cardiol 33:438-443, 1974;.
Zaky A, Nasser WK, Feigenbaum H:  A study of mitral valve action recorded by reflected ultrasound and its application in the diagnosis of mitral stenosis . Circulation 37:789-799, 1968;.
Forker AD, Wilson CS, Weaver WF:  Eisenmenger's syndrome, pulmonary valvular insufficiency and paradoxic septal motion . Chest 65:202-203, 1974;.
McDonald IG:  Echocardiographic demonstration of abnormal motion of the interventricular septum in left bundle-branch block . Circulation 48:272-280, 1973;.
Miller HC, Gibson DG, Stephens JD:  Role of echocardiography and phonocardiography in diagnosis of mitral paraprosthetic regurgitation with Starr-Edwards prosthesis . Br Heart J 35:1217-1225, 1973;.
Feigenbaum H:  Echocardiographic diagnosis of pericardial effusion . Am J Cardiol 26:475-479, 1970;.
Dillon JG, Chang S, Feigenbaum H:  Echocardiographic manifestation of left bundle-branch block . Circulation 49:876-880, 1974;.

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Bemis EL, Pemberton AH, Lurie A:  Rhabdomyosarcoma of the heart . Cancer 29:924-929, 1972;.
Goodman DJ, Harrison DC, Popp RL:  Echocardiographic features of primary pulmonary hypertension . Am J Cardiol 33:438-443, 1974;.
Zaky A, Nasser WK, Feigenbaum H:  A study of mitral valve action recorded by reflected ultrasound and its application in the diagnosis of mitral stenosis . Circulation 37:789-799, 1968;.
Forker AD, Wilson CS, Weaver WF:  Eisenmenger's syndrome, pulmonary valvular insufficiency and paradoxic septal motion . Chest 65:202-203, 1974;.
McDonald IG:  Echocardiographic demonstration of abnormal motion of the interventricular septum in left bundle-branch block . Circulation 48:272-280, 1973;.
Miller HC, Gibson DG, Stephens JD:  Role of echocardiography and phonocardiography in diagnosis of mitral paraprosthetic regurgitation with Starr-Edwards prosthesis . Br Heart J 35:1217-1225, 1973;.
Feigenbaum H:  Echocardiographic diagnosis of pericardial effusion . Am J Cardiol 26:475-479, 1970;.
Dillon JG, Chang S, Feigenbaum H:  Echocardiographic manifestation of left bundle-branch block . Circulation 49:876-880, 1974;.
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